| NPI | 1962469882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 116355) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CT 016190) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2013-08-23 |